You have a 67-year-old newly diagnosed COPD patient. She is…
Questions
Yоu hаve а 67-yeаr-оld newly diagnоsed COPD patient. She is asking for help to stop smoking. What do you recommend?
A 48-yeаr-оld White mаle, Mr. Jаnsen, presents tо the clinic fоr an evaluation of rapid onset of swelling of his left big toe and pain for the past 2 days. The pain is an 8 out 10 on a pain scale (0 indicates no pain and 10 indicates severe pain). The toe is red and warm. He denies injury/trauma to the toe or any decreased range of motion. Past medical history: hypertension Social history: No smoking or illicit drug use. Drinks one or two beers a day and one or two cocktails on the weekends Medications: hydrochlorothiazide 25 mg orally once a day Allergies: no known drug allergies Vital signs: Height 5 feet, 9 inches (1.75 m), weight 198 lbs. (89.81 kg); temperature 98.7°F; pulse 72 beats/minute; respirations 16 breaths/minute; blood pressure 120/80 mmHg; pulse oximeter 99% on room air The review of symptoms is negative for fever, chills, nausea, vomiting, rash, headache, chest pain, palpitations, or shortness of breath. Vital signs: Height 5 feet, 9 inches (1.75 m), weight 198 lbs. (89.81 kg); temperature 98.7°F; pulse 72 beats/minute; respirations 16 breaths/minute; blood pressure 120/80 mmHg; pulse oximeter 99% on room air Physical examination reveals a well-nourished adult male without any acute distress. Significant physical findings include a hot, erythematous, and tender left first metatarsophalangeal joint. Pedal pulses are palpable bilaterally. Gait is steady. Skin is fully intact. Diagnosis: Gout 1- What substance is overproduced or underexcreted in gout? (1 point) 2- Where does the substance (in question 1) come from? (1 point) 3- List two risk factors Mr. Jansen has that predisposes him to gout? (1 point) 4- List two signs/symptoms that Mr. Jansen has that support the diagnosis of gout (2 points)
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